It has been estimated that 120,012 men were killed in action during the American Civil War. A further 64,582 died of their wounds. However, the greatest danger facing soldiers during the war was not bullets but disease. It is believed that 186,216 soldiers died of a variety of different illnesses during the conflict. Large numbers of the soldiers came from rural areas and had not been exposed to common diseases such as chicken pox and mumps. Living in unhealthy conditions and often denied properly medical treatment, soldiers sometimes died of the these diseases. For example, 5,177 soldiers in the Union Army died of measles during the war.
The main killer diseases were those that resulted from living in unsanitary conditions. Union Army records show that a large number of its soldiers died from diseases caused by contaminated food and water. This included diarrhea (35,127), typhoid (29,336) and dysentery (9,431). Drinking from streams occupied by by dead bodies or human waste and eating uncooked meat were the cause of large numbers of deaths. Regular soldiers who had been trained to be more careful about the food and water they consumed, were far less likely to suffer from intestinal disease that volunteer soldiers.
Large numbers of soldiers died from tuberculosis (consumption). Official records show 6,497 soldiers died of the disease in the Union Army. However, a much larger number were discharged because of poor health and died later.
It is estimated that smallpox killed 7,058 Union Soldiers. Another 14,379 died of malaria. Although the exact number of Confederate Army deaths from malaria is not known, there were 41,539 cases in an 18 month period (January, 1862-July, 1863) in South Carolina, Georgia and Florida. The cause of the disease was not known and soldiers often slept without the protection of mosquito nets.
Large numbers of soldiers suffered from combat fatigue. Caused by extreme stress, symptoms include muteness, deafness and difficulty in controlling movement of the limbs. Unrecognized as an illness in the 19th century, soldiers were often diagnosed as suffering from mania or dementia, and sent home to recover. During the First World War combat fatigue was known as shellshock.
Visited Armory Square Hospital. Supplied paper and envelopes to all who wished - as usual, found plenty of men who needed those articles. Wrote letters. Saw and talked with two or three members of the Brooklyn 14th Regiment. A poor fellow in Ward D, with a fearful wound in a fearful condition, was having some loose splinters of bone taken from the neighborhood of the wound. The operation was long, and one of great pain, yet, after it was well commenced, the soldier bore it in silence. He sat up, propped, was much wasted, had lain a long time time quiet in one position (not for days but weeks), a bloodless, brown-skinned face, with eyes full of determination.
One young New York man, with a bright, handsome face, had been lying several months from a disagreeable wound, received at Bull Run. A bullet had shot him right through the bladder, hitting him front, low in the belly, and coming out back. He had suffered much - the water came out of the wound, by slow but steady quantities, for many weeks - so that he lay almost constantly in a sort of puddle - and there were other disagreeable circumstances. At present comparatively comfortable, had a bad throat, was delighted with a stick of horehound candy I gave him, with one or two other trifles.
Our surgeons began to prepare for the coming battle, by appropriating several buildings and fitting them up for the wounded - among others the stone church at Centreville - a church which many a soldier will remember, as long as memory lasts.
The first man I saw killed was a gunner. A shell had burst in the midst of the battery, killing one and wounding three men and two horses. Now the battle began to rage with terrible fury. Nothing could be heard save the thunder of artillery, the clash of steel, and the continuous roar of musketry.
I was sent off to Centreville, a distance of seven miles, for a fresh supply of brandy, lint, etc. When I returned, the field was literally strewn with wounded, dead and dying. Men tossing their arms wildly calling for help; there they lie bleeding, torn and mangled; legs, arms and bodies are crushed and broken as if smitten by thunderbolts; the ground is crimson with blood.
The wounded have begun to arrive from Hooker's command from bloody Chancellorsville. I was down among the first arrivals. The men in charge told me the bad cases were yet to come. If that is so I pity them, for these are bad enough. You ought to see the scene of the wounded arriving on the landing here at the foot of Sixth Street, at night. Two boat loads came about half-past seven last night. the pale, helpless soldiers had been debarked, and lay around on the wharf and neighborhood anywhere. The rain was, probably, grateful to them; at any rate they were exposed to it. The few torches light up the spectacle. All round - on the wharf, on the ground, out on side places - the men are lying on blankets, old quilts, etc., with bloody rags bound round heads, arms, and legs.
The attendants are few, and at night few outsiders also - only a few hard-worked transportation men and drivers. The wounded are getting to be common, and people grow callous. The men, whatever their condition, lie there, and patiently wait till their turn comes to be taken up. The men generally make little or do ado, whatever their sufferings. A few groans that cannot be suppressed, and occasionally a scream of pain as they lift a man into the ambulance. Today, as I write, hundreds more are expected, and tomorrow and the next day more, and so on for many days. Quite often they arrive at the rate of 1000 a day.
Surgeon White came to me and said: "Young man, are you going to have your arm taken off or are you going to lie here and let the maggots eat you up?" I asked if he had any chloroform or quinine or whisky, to which he replied "No, and I have no time to dilly-dally with you." I said it was hard, but to go ahead and take it off. He got hold of my arm, pulled the bandage off, pushed his thumb through the wound and told me to "come on", and helping me up we walked to the amputation table. They put me on the table, cut off blouse and shirt sleeves filled with maggots, and after a lot of preliminary poking and careless feeling around my arm and shoulder they made me sit up in a chair, and wanted to hold my legs, but I said "No, I won't kick you." I set my teeth together and clinched my hand into my hair, and told them to go on. After cutting the top part of my arm and taking out the bone, they wanted me to rest an hour or so; to which I refused. I wanted but one job to it. Then they finished it, while I grasped for breath and the lower jaw dropped in spite of my firm clinch. I was then led away a short distance and left to lie on the hot sand.
The "hospital tree" was an immense tree under whose shady, extended branches the wounded were carried and laid down to await the stimulant, the opiate, or the amputating knife, as the case might require. The ground around the tree was several acres in extent was literally drenched with human blood, and all the men were laid so close together that there was no such thing as passing between them; but each one was removed in their turn as the surgeons could attend to them. Those wounded, but not mortally - how nobly they bore the necessary probings and needed amputations.
In one of the hospitals I find Thomas Haley, company M, 4th New York cavalry. A regular Irish boy, a fine specimen of youthful physical manliness, shot through the legs, inevitably dying. Came over to this country from Ireland to enlist. Is sleeping soundly at this moment (but it is the sleep of death). Has a bullet-hole through the lung. I saw Tom when first brought here, three days since, and didn't suppose he could live twelve hours. Much of the time he sleeps, or half sleeps. I often come and sit by him in perfect silence; he will breathe for ten minutes as softly and evenly as a young babe asleep. Poor youth, so handsome, athletic, with profuse beautiful shining hair. One time as I sat looking at him while he lay asleep, he suddenly, without the least start, awakened, opened his eyes, gave me a long steady look, turning his face very slightly to gaze easier, one long, clear, silent look, a slight sigh, then turned back and went into his doze again.
In one bed a young man, Marcus Small, company K, 7th Maine. Sick with dysentery and typhoid fever. Pretty critical case, I talk with him often. He thinks he will die, looks like it indeed. I write a letter for him to East Livermore, Maine. I let him talk to me a little, but not much, advise him to keep very quiet. Do most of the talking myself, stay quite a while with him, as he holds on to my hand.
Opposite, an old Quaker lady sits by the side of her son, Amer Moore, 2nd U.S. Artillery. Shot in the head two weeks since, very low, quite rational, from hips down paralyzed, he will surely die. I speak a very words to him every day and evening. He answers pleasantly, wants nothing. He told me soon after he came about his home affairs, his mother had been an invalid, and he feared to let her know his condition. He died soon after she came.
I was called at midnight to a death-bed. It was a case of flesh-wound in the thigh, and the whole limb was swollen almost to bursting, so cold as to startle by the touch, and almost as transparent as glass. I knew this was piemia and that for it medical science had no cure; but I wanted to warm that cold limb, to call circulation back to that inert mass. The first thought was warm, wet compresses, hot bricks, hot flannel; but the kitchen was locked, and it was little I could do without fire, except to receive and write down his dying messages to parents, and the girl who was waiting to be his wife.
When the surgeon's morning hour came he still lived; and at my suggestion the warm compresses were applied. He said, "they feel so good," and was quite comforted by them, but died about ten o'clock. I was greatly grieved to think he had suffered from cold the last night of life, but how avoid any number of similar occurrences? There was no artificial heat in any of the wards. A basin of warm water was only to be obtained by special favor of the cooks.
I decided to lay my trouble before the cooks, who gathered to hear me tell the story of that death and of my sorrow that I could not drive away the cold on that last, sad night.
They all wiped their eyes on their aprons; head cook went to a cupboard, brought a key and handed it to me, saying:
"There, mother, is a key of this kitchen; come in here whenever you please. We will always find room on the ranges for your bricks, and I'll have something nice in the cupboard every night for you and the nurses."
This proved to be the key to the situation, and after I received that bit of metal from cook, there was not one death from piemia in any ward where I was free to work, although I have had as many, I think, as sixty men struck with the premonitory chill, in one night. I concluded that "piemia" was French for neglect, and that the antidote was warmth, nourishing food, stimulants, friction, fresh air and cheerfulness, and did not hesitate to say that if death wanted to get a man out of my hands, he must send some other agent than piemia. I do not believe in the medical theory concerning it; do not believe pus ever gets into the veins, or that there is any poison about it, except that of ignorance and indifference on the part of doctors and nurses.